Liposuction for Lipedema and Lymphedema

This policy covers suction-assisted protein lipectomy (liposuction), including subsequent revisions, for treatment of lipedema and for documented lymphedema when all specified medical necessity criteria are met. Coverage is limited to patients with documented disease (e.g., lipedema with bilateral symmetric extremity adiposity, non‑pitting edema, negative Stemmer sign, tissue tenderness, or lymphedema with functional impairment or complications such as recurrent cellulitis) who have failed ≥3 months of optimal conservative therapy, have required clinical exam findings and photographs, a postoperative compression plan, and meet all plan- and state-specific benefit requirements and exclusions.

"Medically necessary reconstructive services intended to restore the physical appearance of body structures damaged by trauma."

Sign up to see full coverage criteria, indications, and limitations.